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5 - Neurobiology of disaster exposure: fear, anxiety, trauma, and resilience

from Part II - Foundations of disaster psychiatry

Published online by Cambridge University Press:  09 August 2009

By
Rebecca P. Smith ,
Craig L. Katz ,
Dennis S. Charney  and
Steven M. Southwick
Edited by
Robert J. Ursano ,
Carol S. Fullerton ,
Lars Weisaeth  and
Beverley Raphael
Rebecca P. Smith
Affiliation:
Assistant Clinical Professor World Trade Center Worker and Volunteer Mental Health Screening, Monitoring and Interventions Programs
Craig L. Katz
Affiliation:
Assistant Clinical Professor Psychiatry Mount Sinai School of Medicine
Dennis S. Charney
Affiliation:
Professor Psychiatry Mount Sinai School of Medicine
Steven M. Southwick
Affiliation:
Professor Section of Child Study Center Yale University
Robert J. Ursano
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Carol S. Fullerton
Affiliation:
Uniformed Services University of the Health Sciences, Maryland
Lars Weisaeth
Affiliation:
Universitetet i Oslo
Beverley Raphael
Affiliation:
University of Western Sydney
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Summary

Introduction

To date, clinical and research approaches to disaster mental health have focused primarily on the psychological experience of disaster survivors, and the development and effectiveness of psychological treatments. While these studies have contributed greatly to our understanding of the human response to disaster, it has become clear in recent years that, in addition to psychological approaches, neurobiological approaches to disaster-related psychopathology and resilience are also potentially informative.

Multiple neurobiological systems are involved in the human response to threat. Simultaneous activation of various brain regions and neurotransmitter systems allows the organism to assess and appropriately respond to potential dangers. This dynamic process contributes to the development of anxiety, fear, and the “fight or flight” response that allows the organism to protect itself by either fleeing from, or actively confronting, danger. Fear triggers the familiar “fight or flight” response, characterized by acute increased heart rate, breathing, and muscle tension, which facilitate escape from danger or defense against danger (e.g., predator). Based on a complex process of recognition and appraisal of internal and external stimuli, the brain regulates the strength and duration of this coping mechanism, and generally turns it off when it is appropriate to do so. Malfunction of regulatory systems, however, can lead to excessive fear, anxiety disorders such as post-traumatic stress disorder (PTSD) and significant impairment and disability in vulnerable individuals.

Keywords

disasterHPA axisneurobiological modelsneurobiological resiliencePTSDsympathetic nervous systempharmacological interventionneuroimaging
Type
Chapter
Information
Textbook of Disaster Psychiatry , pp. 97 - 118
Publisher: Cambridge University Press
Print publication year: 2007

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